Study of interstitial lung diseases at a tertiary care center

Authors : Ramakrishna Rachakonda, Ramakrishna Rachakonda, Nandeeswara Reddy CV, Nandeeswara Reddy CV

DOI : 10.18231/2581-4222.2018.0032

Volume : 3

Issue : 3

Year : 0

Page No : 121-126

Introduction: Interstitial Lung Diseases are frequent causes of morbidity and mortality and are frequently diagnosed because of the usage of High Resolution Computerised Tomography (HRCT). Interstitial Lung Diseases (ILDs) result from known and unknown causes and result in variable amount of interstitial and pulmonary parenchymal inflammation and fibrosis.
Material and Methods: A total of 104 patients diagnosed on the basis of clinical and radiological criteria as interstitial Lung disease attending Katuri Medical College Hospital, Guntur from June 2015 to June 2018 above 18 years of age were taken in to the study.
Results: Predominant interstitial lung disease was idiopathic interstitial fibrosis (IPF) (46%). Non-IPF interstitial lung diseases constituted 56%. Females outnumbered males in our study with a ratio of 1.7:1. Mean age of the ILD patients was 50.19. Cough and breathlessness were universal in our ILD patients. There are equal number of smokers and nonsmokers. > 75% of patients presented with Grade II MMRC or more. 75% of our patients of ILD desaturated on 6 minute walk testing. PFT revealed restrictive pattern in 69%, mixed pattern in 26.92% and obstructive pattern in 4%. 50% of patients had DLCO of more than 60%. Smoking history correlated with decrease in DLCO. BAL fluid analysis suggested neutrophilic preponderance in 42% and lymphocytic preponderance in 58%.Basing on the clinical and radiological criteria IPF was diagnosed in 46%, NSIP in 21%, NSIP CTD in 12% and Hypersensitivity Pneumonitis in 14%. 62.5% had associated pulmonary arterial hypertension. Smoking history correlated with presence of PAH.
Conclusions: ILDs are common in clinical practice. Diagnosed predominantly after the frequent usage of HRCT in symptomatic patients. History analysis, clinical examination, chest X-ray, bronchoscopy, bronchoalveolar lavage (BAL), pulmonary Function Testing, six minute walk test, echocardiography, carbon dioxide diffusion capacity (DLCO) testing help in the diagnosis.

Keywords: Desaturation; Sarcoidosis; Hypersensitivity pneumonitis; Pulmonary arterial hypertension.


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